Post on 12-Jan-2016
description
Debra Moore debra@debramooreassociates.com
www.debramooreassociates.com07950 333884
Health action planning and health facilitation
Problems, progress and priorities
Context “The NHS is there
when we need it most. It provides round the clock, compassionate care and comfort”
Lord Ara Darzi
“Witnesses described some appalling examples of discrimination, abuse and neglect across the range of health services”
Sir Johnathon Michaels
Am I bovvered? You are here! Main agencies and organisations
have this in their ‘sights’ and are here
Lots of mainstream examples of good practice e.g. Sheffield
Acknowledge competing demands and financial climate
Recognise inevitable ‘higher priorities’ and ‘play our hand’ accordingly
Yes!
Health action planning & health facilitation Finding out…..
We met with a range of people at several events and canvassed view
We heard about the issues emerging from research in this area
We looked at good practice and ‘what helped and what hindered’
We looked at VP targets in this area and issues relating to Learning Disability Partnership Boards
Considered changes in the policy landscape and new mechanisms to support change e.g. JSNA
Health Action Planning and Health Facilitation - what we heard……
VP Targets for health action planning and health facilitation not hit in many areas
Many areas lack an up to date ‘Action for Health Framework’ and lack local evidence, data or outcome measures
Health has not enough ‘air time’ at many Learning Disability Partnership Boards
Some LDPB’s don’t have a health subgroup or its poorly attended or not right people there
Some LDPB’s failed to make the relationships with commissioners and providers of mainstream and specialist health services
Ultimately – undermines not just achievement of VP targets but ability to address DRC, Mencap, Michaels, Healthcare Commission audit etc etc etc
So has it been a missed opportunity?
Yeah, but no, but!
What helped locally?
Taking an honest but constructive approach Leadership - a critical factor ‘Ownership’ by the mainstream Emphasising the wider benefits to all groups Involving people and families who have
appropriate skills and knowledge in training Performance management – SHA’S, PCT’s
and Healthcare Commission Incentivising the system – LES & DES Seeing HF and HAP as part of a wider health
agenda – ‘tools’ or means to an end rather than the end game
Lots of good practice examples – so it can be done!
What did people say?Good 1:1 health
facilitators
Know and trusted by the person Puts the person at the centre of
plan Works closely with those who
know and love them Know a lot about the persons
health needs and wishes and rights
Know how to access opticians, dentists, GP etc
Good communicator Knows how to format a plan
that is useful to the individual
Good strategic health facilitators
Good leaders Know about the health needs of
people with learning disabilities Understand how health services are
commissioned and delivered Can monitor and audit intiatives to
reduce inequalities Can work across a locality and
different agencies and services Understand mainstream and
specialist health policy
What did people say – Health Action Plans
Don’t have just one approach/format – need to be useful to the person
Need to have some ‘documentation’ that looks similar that health professionals recognise e.g. ‘grab sheets’ etc
Provide training and resources for people and families as well as health and social care professionals
Make good use of universal services Need to make sure health action planning it is a part of person
centred planning (and CPA where appropriate)
“Style and format less important that explaining the plan clearly and ensuring actions take place”
Primary Care Trusts some key messages from the field
‘Commission to improve outcomes’ - data and evidence and LD population needs and wishes should be seen within commissioning strategies and priorities
Provide leadership within the PCT, at the Learning Disability Partnership Board and beyond
Harness the expertise of specialist health provision and maximise contribution e.g. CTLD’s
Lead the delivery of the local Action for Health Framework and related strategies e.g. ‘Green Light’
key messages- continued Invest in posts that assist the PCT to deliver the
changes required e.g. Strategic Health Facilitation and deliver provider support e.g. Acute Liaison Nurses
Employ coherent data systems to monitor GP registration, the uptake of health checks and health action plans
Make sure that local health policies and practices are assessed (Equality Impact Assessments).
Undertake reasonable adjustments - including mental health and offender health services
Utilise Primary Care Service Framework and associated tools
Learning Disability Partnership Boards need to vaccinate against the ‘Dibleys’
Have the right people at the Board and the health subgroup – expertise and authority – earn their place!
Make sure they have a firm grip of the health agenda – be business like!
Have good evidence of what works and what’s not working nationally and locally
Have clear outcomes and develop locally relevant metrics that include social care and universal supports e.g. uptake in sport
Harness the skills of people and families (especially those with more ‘complex needs’)
Be decisive and get on with it - do what you can, where you can and do it now!
Action for Health Frameworks
‘Gearing up the different parts to work together’
‘Better health’ sits within a ‘broader context’We need to make sure everyone understandsthe implications for people’s lives and theachievement of their hopes and dreams
This IS a matter of ‘LIFE AND DEATH’